Neuro trauma can completely disrupt the way a person feels, thinks and behaves. Whether it’s from a mild concussion, severe traumatic brain injury, stroke or aneurysm – neuro trauma causes a wide variety of deficits including long and short term memory loss, impulsivity, mood swings and many other social, cognitive and behavioral issues. Two of the most commonly recommended treatments also happen to be the most commonly mistaken for each other: Cognitive Behavioral Therapy (CBT) and Cognitive Rehabilitation Therapy (CRT). So, what’s the difference?

Cognitive Behavioral TherapyCognitive Behavioral Therapy is effective for treating a variety of conditions such as mood, anxiety, personality, eating, addiction, dependence and psychotic disorders. Cognitive Behavioral Therapy replaces distorted or negative thoughts with more realistic ones to decrease emotional distress and self-defeating behavior. Simply put: if you change the way you think, you can change the way you feel and behave.

Drug addiction is commonly treated with Cognitive Behavioral Therapy. The therapist helps enable the patient to see how their thoughts, feelings and behavior patterns interact to trigger their urge to use drugs. From here, the therapist can determine the source of the patient’s problematic relationship with drugs. For example, feelings of depression may lead to self-destructive thoughts which, in turn, may result in the patient using drugs. The therapist targets negative feelings that start the cycle of abuse by helping the patient develop a positive self-worth. By altering thoughts like negative self-talk and self-isolation that can lead to drug-seeking behavior, Cognitive Behavioral Therapy helps end the negative feedback loop of addiction in a patient’s life. Even when therapy is complete, patients are advised to continue practicing CBT so they can maintain a positive outcome.

Cognitive Rehabilitation TherapyCognitive Rehabilitation Therapy is the process of mentally redeveloping the cognitive skills and function lost due to brain injury. These skills include intellectual performance, problem solving, attention deficits, memory and language difficulties. The key measure of CRT is the patient’s level of cognitive function. If the patient cannot relearn the lost skills, then the therapists teaches compensatory strategies. These strategies can literally be anything that helps the patient redevelop and maintain their independence. For example, a patient with short term memory problems could learn to set an alarm on his phone to remind him to take his medication.

Basic Cognitive Rehabilitation Therapy (CRT) included four components: 1) Assessment, education and awareness development of cognitive strengths and weaknesses, 2) skill development concentrating on resolving defined cognitive deficits, 3) compensatory strategy training and 4) functional activities that involve applying the first three components of CRT to everyday life.​At Life Skills Village, our therapists assess and treat patients’ cognitive skills by focusing BOTH on building upon the patient’s strengths while strategically shoring up their weaknesses. But what if a patient has a deficit that cannot be rebuilt? This is where the therapist’s list of compensatory strategies comes in – for every deficit, there is at least one compensatory strategy. A patient experiencing difficulties with short-term memory will have several strategies for them to try: there are many smart phone apps to help organize schedules and act as a reminder for events. Patients can develop the habit of taking notes in doctor’s appointments. They might keep a calendar on their refrigerator at home to know where they are scheduled to be on any particular day. Even maintaining a simple “thought” journal can aid patients in tracking their emotions in relation to daily events.

Although both Cognitive Behavioral Therapy and Cognitive Rehabilitation Therapy maintain a focus on cognition, they are distinct therapies designed to address specific cognitive concerns. Cognitive Behavioral Therapy is used to treat mental conditions such as anxiety or depression by focusing on an emotional or behavioral issue. The goal is to change a patient’s perception in order to decrease self-defeating behaviors, improve their mood and develop healthy thought patters. Cognitive Rehabilitation Therapy employs a broad range of cognition-based therapies to assist patients with cognitive deficits, such as memory, attention and executive function. The goal is to improve cognitive function and processes. Using these and a myriad of other therapies, Life Skills Village facilitates independence and a return to normal life for our clients after their injuries.

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About the Doc

Dr. Bryan Weinstein is a practicing psychiatrist with certification from the American Board of Psychiatry and Neurology. He has practiced psychiatric pharmacology and psychotherapy since 1997. Dr. Weinstein is the CEO of Life Skills Village.